Palliative Care Education - Anytime, Anywhere

Hospice COVID-19 Unit Offers Patients, Families Needed Support

By Larry Beresford

Some Louisiana families whose loved ones are dying from COVID-19 have found solace in a specialized hospice unit that is caring for patients infected with the virus.

Heart of Hospice Inc. opened its inpatient COVID-19 unit on April 15 in Metairie, a suburb of New Orleans. The company, headquartered in Charleston, S.C., with locations in five states, is one of several hospices across the country opening or converting inpatient facilities to serve COVID-19 patients.

In hospitals and other acute-care settings, patients with the virus are isolated, with visitors banned to lower the risk of new infections. Those dying from COVID-19 are often alone or surrounded by strangers, a heartbreaking scenario for patients, families, and bedside clinicians.

Offering another option has been a priority for hospices that have the resources and abilities to make it happen. Specialized COVID-19 hospice units have been a godsend for patients nearing death and their families.

A Unique Healthcare Decisions Day

COVID-19 Crisis Illustrates Importance of Advance Care Planning

By Larry Beresford

As healthcare professionals across America grapple with or prepare for a surge of COVID-19 cases, ICU placements, and deaths, many are emphasizing the importance of advance care planning to help people clarify their medical wishes and values.

Susan Enguidanos, PhD, associate professor in the USC Leonard Davis School of Gerontology

Advance care planning encourages us to think about what kind of medical care we would want if we were too sick to express our wishes, while advance directives are a tool used to document certain healthcare decisions.

On April 16, National Healthcare Decisions Day, it is worth asking how the COVID-19 pandemic has reinforced or changed our ideas about advance care planning. Experts say it has created unique opportunities for people to talk about difficult topics like the possibility of a catastrophic illness.

“This year’s National Healthcare Decisions Day may be the most important one we’ve ever had,” said Susan Enguidanos, PhD, a palliative care researcher and associate professor at the University of Southern California Leonard Davis School of Gerontology. “Many of us have more time on our hands as we are sheltering at home. You can take a little time, have the conversation with your loved ones, and talk about worst-case scenarios.”

March 26, 2020 (SAN DIEGO) – The CSU Shiley Institute for Palliative Care announced this week it is making more than 20 online palliative care courses and resources immediately available at no charge to support healthcare clinicians on the frontlines of the COVID-19 pandemic.

These courses deliver critical skills needed now to best care for patients and families affected by this crisis. Topics include clinician communication, advance care planning, palliative care skills for generalists, crisis intervention strategies, self-care, and more.

As infection rates skyrocket, healthcare professionals are struggling under extraordinary circumstances to treat illness, manage symptoms, and ease suffering for patients with serious illness and/or advanced age who are most at risk for severe complications or death from the novel coronavirus.

The many strengths of palliative care – communication, difficult decision making, advance care planning, pain and symptom management, and psychosocial/spiritual support — are needed now more than ever.

The Institute’s free COVID-19 palliative care resources will be available through June 30 to anyone caring for patients and families during this crisis. Courses are self-paced and can be completed anywhere, any time.

The Role of Palliative Care in a COVID-19 Pandemic

Palliative Care Strengths Such as Communication, Advance Care Planning, and Symptom Management, Needed Now More Than Ever

By Jennifer Moore Ballentine

In this time of the COVID-19 pandemic, healthcare systems and healthcare professionals are stressed and bracing for or already managing an influx of affected patients. The coronavirus presents a severe acute care crisis of unknown duration, in which potentially hundreds of thousands of people may get sick, some critically, and tens of thousands may die.[1]

In this context, the usual concerns of palliative care—quality of life, discernment of patient goals, advance care planning, pain and symptom management, and support for caregivers over protracted trajectories—seem pale and to pale in comparison. And yet, I would argue, palliative care has never been more important.

Those who are elderly, frail, and/or with underlying chronic or serious illness are most at risk from the novel coronavirus. These are palliative care’s core patient population. Utilizing the unique skills and strengths found in palliative care must be part of the response.

The Best Way to Support Family Caregivers? Train the Palliative Care Workforce

By Jennifer Moore Ballentine

A letter to the editor of the New England Journal of Medicine made big news at the end of last year: “Home has surpassed the hospital as the most common place of death in the United States for the first time since the early 20th century”! This has been a driving impetus behind hospice and palliative care for 40+ years: to close the gap between the percentage of people (variously reported between 70 and 80%) who WANT to die at home and those that DO (typically reported, based on stats from the 1990s at ~20%).

When the scales tipped you would think the hallelujahs would ring out loud and long! But no! Almost immediately the conversation changed from lamenting the percentage of people not dying at home to lamenting the enormous burden placed on family caregivers to make such a place of death possible. Gotta say, I and others in palliative care are feeling a sense of whiplash!